This proposal requests funding to create a new WTC Clinical Center of Excellence at the Mount Sinai School of Medicine that will unite the existing Mount Sinai World Trade Center Medical Monitoring Program Clinical Center and the World Trade Center Health Effects Treatment Program. In this new Medical Monitoring and Treatment Program (MMTP) monitoring examinations will continue to be provided to WTC responders according to the protocol now used for the WTC Medical Monitoring Program. Patients are seen at 18-month intervals, and they will now receive treatment for WTC-related conditions at the time of their monitoring examination. An integral part of the program is the provision of social work services to assist patients in obtaining health benefits, workers compensation, 9/11 related benefits and other needed services. Specific aims of this project are: 1. to operate a Clinical Center of Excellence in occupational medicine that will be a key component of a network of clinics and that will provide comprehensive health monitoring and treatment services for World Trade Center (WTC) responders. 2. To develop protocols for in-patient and outpatient treatment of WTC related health conditions for implementation within the Mount Sinai Center of Excellence and at appropriate referral sites. 3. To assist WTC responders and their families in obtaining health benefits, workers compensation and other appropriate services. 4. To provide the health findings that arise from the monitoring and treatment program to the WTC Data Coordination Center for aggregation, analysis, dissemination and quality control. 5. To continually evaluate and revise, as necessary, the monitoring and treatment protocols, using best available evidence from the findings from the Data Coordination Center, from the clinical experiences gained from the ongoing monitoring and treatment, and from other WTC responder clinical and research programs. Establishment of this new Center of Excellence will enable WTC responders to receive comprehensive free, confidential care for WTC-related conditions within a single, unified program. We anticipate that over the next 32 months MMTP will provide periodic medical examinations for approximately 15,000 responders and provide treatment to an estimated 6200 of these men and women. [unreadable] [unreadable] [unreadable] [unreadable]